NUR 114
EXAM 3
NCLEX Style Questions w/
Rationales & Test Taking Strategies
Jefferson State Community College
This Document Description:
❖ This document contains NCLEX-style Exam
questions tailored to the NUR 114 course at
Jefferson State Community College.
❖ It covers core topics assessed in the course
and reflects the actual exam format and question style.
❖ Each question is followed by a correct answer, rationale, and
test-taking strategy to support exam preparation.
,The nurse is planning care for a child with hemolytic-uremic syndrome
who has been anuric and will be receiving peritoneal dialysis treatment.
The nurse would plan to implement which measure?
1. Restrict fluids as prescribed.
2. Care for the arteriovenous fistula.
3. Encourage foods high in potassium.
4. Administer analgesics as prescribed.
Answer: 1
Rationale: Hemolytic-uremic syndrome is thought to be associated with
bacterial toxins, chemicals, and viruses that result in acute kidney injury in
children. Clinical manifestations of the disease include acquired hemolytic
anemia, thrombocytopenia, renal injury, and central nervous system
symptoms. A child with hemolytic-uremic syndrome undergoing peritoneal
dialysis because of anuria would be on fluid restriction. Pain is not associated
with hemolytic-uremic syndrome, and potassium would be restricted, not
encouraged, if the child is anuric. Peritoneal dialysis does not require an
arteriovenous fistula (only hemodialysis).
Test-Taking Strategy: Note the subject, anuria. Focus on the child’s diagnosis,
and recall knowledge about the care of a client with acute kidney injury. Also
focus on the data in the question. Noting the word peritoneal will assist in
eliminating option 2. From the remaining options, remember that because the
child is anuric, fluids will be restricted.
An infant of a birth parent infected with human immunodeficiency virus
(HIV) is seen in the clinic each month and is being monitored for
symptoms indicative of HIV infection. With knowledge of the most
common opportunistic infection of children infected with HIV, the nurse
assesses the infant for which sign?
1. Cough
2. Liver failure
3. Watery stool
4. Nuchal rigidity
Answer: 1
,Rationale: Acquired immunodeficiency syndrome (AIDS) is a disorder caused
by HIV and characterized by generalized dysfunction of the immune system.
The most common opportunistic infection of children infected with HIV is
Pneumocystis jiroveci pneumonia, which occurs most frequently between the
ages of 3 and 6 months, when HIV status may be indeterminate. Cough is a
common sign of this opportunistic infection. Cytomegalovirus infection is also
characteristic of HIV infection; however, it is not the most common
opportunistic infection. Liver failure is a common sign of this complication.
Although gastrointestinal disturbances and neurological abnormalities may
occur in a child with HIV infection, options 3 and 4 are not specific
opportunistic infections noted in the HIV-infected child. Watery stool is noted
with gastroenteritis, and nuchal rigidity is seen in meningitis.
Test-Taking Strategy: Note the strategic word, most. This will direct you to the
correct option. Also use of the ABCs—airway breathing, and circulation—will
assist in answering correctly. Remember that the most common opportunistic
infection of children infected with HIV is P. jiroveci pneumonia and that cough
is a common sign with this complication.
The nurse provides home care instructions to the parent of a child with
acquired immunodeficiency syndrome (AIDS). Which statement by the
parent indicates the need for further teaching?
1. "I will wash my hands frequently."
2. "I will keep my child's immunizations up to date."
3. "I will avoid direct unprotected contact with my child's body fluids."
4. "I can send my child to day care with a fever as long as it is a low-grade
fever."
Answer: 4
Rationale: AIDS is a disorder caused by human immunodeficiency virus (HIV)
and characterized by generalized dysfunction of the immune system. A child
with AIDS who is sick or has a fever needs to be kept home and not brought to
a day care center. Options 1, 2, and 3 are correct statements and would be
actions a caregiver needs to take when the child has AIDS.
, Test-Taking Strategy: Note the strategic words, need for further teaching.
These words indicate a negative event query and ask you to select an option
that is an incorrect statement. Noting the word fever in the correct option will
direct you to this option.
The clinic nurse is instructing the parent of a child with human
immunodeficiency virus (HIV) infection regarding immunizations. The
nurse would provide which instruction to the parent?
1. The hepatitis B vaccine will not be given to the child.
2. The inactivated influenza vaccine will be given yearly.
3. The varicella vaccine will be given before 6 months of age.
4. A Western blot test needs to be performed and the results evaluated
before immunizations.
Answer: 2
Rationale: Immunizations against common childhood illnesses are
recommended for all children exposed to or infected with HIV. The inactivated
influenza vaccine that is given intramuscularly will be administered (influenza
vaccine would be given yearly). The hepatitis B vaccine is administered
according to the recommended immunization schedule. Varicella-zoster virus
vaccine would not be given, because it is a live virus vaccine; varicella-zoster
immunoglobulin may be prescribed after exposure to chicken pox. Option 4 is
unnecessary and inaccurate.
Test-Taking Strategy: Focus on the subject, immunizations for the child with
HIV. Option 4 can be eliminated first because the Western blot is a diagnostic
test, not an evaluative test. From the remaining options, recalling that the child
infected with HIV is at risk for opportunistic infections and that live virus
vaccines are not administered to an immunodeficient child will assist in
directing you to the correct option.
A pediatrician prescribes laboratory studies for the infant of a birthing
parent positive for human immunodeficiency virus (HIV). The nurse
anticipates that which laboratory study will be prescribed for the infant?
1. Chest x-ray
2. Western blot
EXAM 3
NCLEX Style Questions w/
Rationales & Test Taking Strategies
Jefferson State Community College
This Document Description:
❖ This document contains NCLEX-style Exam
questions tailored to the NUR 114 course at
Jefferson State Community College.
❖ It covers core topics assessed in the course
and reflects the actual exam format and question style.
❖ Each question is followed by a correct answer, rationale, and
test-taking strategy to support exam preparation.
,The nurse is planning care for a child with hemolytic-uremic syndrome
who has been anuric and will be receiving peritoneal dialysis treatment.
The nurse would plan to implement which measure?
1. Restrict fluids as prescribed.
2. Care for the arteriovenous fistula.
3. Encourage foods high in potassium.
4. Administer analgesics as prescribed.
Answer: 1
Rationale: Hemolytic-uremic syndrome is thought to be associated with
bacterial toxins, chemicals, and viruses that result in acute kidney injury in
children. Clinical manifestations of the disease include acquired hemolytic
anemia, thrombocytopenia, renal injury, and central nervous system
symptoms. A child with hemolytic-uremic syndrome undergoing peritoneal
dialysis because of anuria would be on fluid restriction. Pain is not associated
with hemolytic-uremic syndrome, and potassium would be restricted, not
encouraged, if the child is anuric. Peritoneal dialysis does not require an
arteriovenous fistula (only hemodialysis).
Test-Taking Strategy: Note the subject, anuria. Focus on the child’s diagnosis,
and recall knowledge about the care of a client with acute kidney injury. Also
focus on the data in the question. Noting the word peritoneal will assist in
eliminating option 2. From the remaining options, remember that because the
child is anuric, fluids will be restricted.
An infant of a birth parent infected with human immunodeficiency virus
(HIV) is seen in the clinic each month and is being monitored for
symptoms indicative of HIV infection. With knowledge of the most
common opportunistic infection of children infected with HIV, the nurse
assesses the infant for which sign?
1. Cough
2. Liver failure
3. Watery stool
4. Nuchal rigidity
Answer: 1
,Rationale: Acquired immunodeficiency syndrome (AIDS) is a disorder caused
by HIV and characterized by generalized dysfunction of the immune system.
The most common opportunistic infection of children infected with HIV is
Pneumocystis jiroveci pneumonia, which occurs most frequently between the
ages of 3 and 6 months, when HIV status may be indeterminate. Cough is a
common sign of this opportunistic infection. Cytomegalovirus infection is also
characteristic of HIV infection; however, it is not the most common
opportunistic infection. Liver failure is a common sign of this complication.
Although gastrointestinal disturbances and neurological abnormalities may
occur in a child with HIV infection, options 3 and 4 are not specific
opportunistic infections noted in the HIV-infected child. Watery stool is noted
with gastroenteritis, and nuchal rigidity is seen in meningitis.
Test-Taking Strategy: Note the strategic word, most. This will direct you to the
correct option. Also use of the ABCs—airway breathing, and circulation—will
assist in answering correctly. Remember that the most common opportunistic
infection of children infected with HIV is P. jiroveci pneumonia and that cough
is a common sign with this complication.
The nurse provides home care instructions to the parent of a child with
acquired immunodeficiency syndrome (AIDS). Which statement by the
parent indicates the need for further teaching?
1. "I will wash my hands frequently."
2. "I will keep my child's immunizations up to date."
3. "I will avoid direct unprotected contact with my child's body fluids."
4. "I can send my child to day care with a fever as long as it is a low-grade
fever."
Answer: 4
Rationale: AIDS is a disorder caused by human immunodeficiency virus (HIV)
and characterized by generalized dysfunction of the immune system. A child
with AIDS who is sick or has a fever needs to be kept home and not brought to
a day care center. Options 1, 2, and 3 are correct statements and would be
actions a caregiver needs to take when the child has AIDS.
, Test-Taking Strategy: Note the strategic words, need for further teaching.
These words indicate a negative event query and ask you to select an option
that is an incorrect statement. Noting the word fever in the correct option will
direct you to this option.
The clinic nurse is instructing the parent of a child with human
immunodeficiency virus (HIV) infection regarding immunizations. The
nurse would provide which instruction to the parent?
1. The hepatitis B vaccine will not be given to the child.
2. The inactivated influenza vaccine will be given yearly.
3. The varicella vaccine will be given before 6 months of age.
4. A Western blot test needs to be performed and the results evaluated
before immunizations.
Answer: 2
Rationale: Immunizations against common childhood illnesses are
recommended for all children exposed to or infected with HIV. The inactivated
influenza vaccine that is given intramuscularly will be administered (influenza
vaccine would be given yearly). The hepatitis B vaccine is administered
according to the recommended immunization schedule. Varicella-zoster virus
vaccine would not be given, because it is a live virus vaccine; varicella-zoster
immunoglobulin may be prescribed after exposure to chicken pox. Option 4 is
unnecessary and inaccurate.
Test-Taking Strategy: Focus on the subject, immunizations for the child with
HIV. Option 4 can be eliminated first because the Western blot is a diagnostic
test, not an evaluative test. From the remaining options, recalling that the child
infected with HIV is at risk for opportunistic infections and that live virus
vaccines are not administered to an immunodeficient child will assist in
directing you to the correct option.
A pediatrician prescribes laboratory studies for the infant of a birthing
parent positive for human immunodeficiency virus (HIV). The nurse
anticipates that which laboratory study will be prescribed for the infant?
1. Chest x-ray
2. Western blot
